Is Aspirin Safe for Newborns? Risks and Recommendations

Q: Is Aspirin Safe for Newborns? Risks and Recommendations

Hello： 1. Definition of Fever： * Rectal temperature (or ear temperature) exceeding 38°C or axillary temperature exceeding 37°C. * Axillary temperature is the lowest, while rectal temperature is the highest. Axillary temperature is 1°C lower than rectal (or

The use of aspirin in newborns is not considered safe?

Dear Pharmacist,
My daughter, who is not yet one month old, was taken to Clinic A for a consultation, where the doctor diagnosed her with a cold and fever, prescribing Nicotinamide and Aspirin.
The medication is to be taken four times a day, and there is also a red packet with an unclear composition.
I have searched your site and found previous consultations mentioning that Aspirin is not recommended as an antipyretic for children, which makes me very concerned.

I would like to ask the pharmacist if it is appropriate for a newborn to use this medication so frequently? Is it truly necessary to use this medication in every packet? After using the medication, her stool has shown yellow, transparent mucus; does this indicate that her gastrointestinal tract has been harmed? This medication has been used for 8 days, and my family still feels that she feels warm to the touch.
We sought medical advice again, and the same medication was prescribed.
Doctor A believes that a temperature of 37 degrees Celsius is considered a fever, as we measured an axillary temperature of 38 degrees Celsius during her crying (not sure if an additional 0.5 degrees was added).
This fever standard differs from the one used at the hospital where I gave birth (where 37.5 degrees is considered normal).
How should I choose?
I sincerely request your guidance.
Thank you.

Lin, 20~29 year old female. Ask Date: 2005/05/13

Dr. Hou Fangmin reply Pharmacology

Hello:
1.
Definition of Fever:
* Rectal temperature (or ear temperature) exceeding 38°C or axillary temperature exceeding 37°C.

* Axillary temperature is the lowest, while rectal temperature is the highest.
Axillary temperature is 1°C lower than rectal (or ear) temperature, and 0.5°C lower than oral temperature.

* Do not rely solely on touch to determine if a child has a fever.
2.
Causes of Fever and Injection Considerations:
* Fever is a clinical symptom indicating a potential underlying infection or inflammation.

* The causes can range from mild to severe, with some potentially life-threatening, necessitating treatment targeting the underlying cause for the fever to resolve completely.

* Therefore, it is essential to monitor related symptoms (e.g., runny nose, diarrhea, vomiting, etc.) to identify the cause for treatment.

* Important considerations: decreased energy levels, prolonged fever (lasting more than 2-3 days), high fever persisting (> 40°C), multiple fevers in one day, appearance of new symptoms, or other unmanageable issues.
If any of these conditions occur, seek immediate medical attention at the emergency department or outpatient clinic.
3.
Principles of Fever Management:
1.
Non-pharmacological approaches:
* Ensure good air circulation indoors and adjust room temperature.

* Increase fluid intake, rest adequately, and avoid excessive activity.

* For rectal (or ear) temperatures exceeding 38°C, use a water pillow (for infants under three months) or an ice pillow.

* For rectal (or ear) temperatures exceeding 39.5°C, a lukewarm bath may be appropriate.
2.
Pharmacological treatment:
* Acetaminophen is commonly used to reduce fever.

* Caution is advised when using aspirin in children.

* Aspirin, known for its analgesic and antipyretic properties, can also inhibit the release of tissue-damaging enzymes, reducing microvascular permeability, thus having anti-inflammatory effects.

Indications for treatment:
1.
Fever, headaches, muscle pain, joint pain, and various other pains caused by colds.

2.
It can help prevent heart disease and strokes.

Dosage:
* It is advisable not to take on an empty stomach; consume some food or drink a glass of milk before taking it.

* Generally, one tablet per dose, three times a day for mild conditions.
For more severe conditions, one tablet every four hours.

Side effects:
* Common side effects include gastrointestinal discomfort, mild nausea, and vomiting.

* If you are concerned, you may ask your physician why aspirin is being used to reduce fever, as it has many uses.

I hope this explanation is helpful.
Thank you for your question, and I wish you peace and happiness.

Reply Date: 2005/05/13

More Info

Aspirin is generally not recommended for use in newborns and young children due to several safety concerns. The primary reason for this caution is the association of aspirin with Reye's syndrome, a rare but serious condition that can cause swelling in the liver and brain, particularly in children recovering from viral infections. Given that your newborn is under one month old, the use of aspirin is particularly concerning.

In the case you presented, the physician prescribed aspirin for fever management, which raises several questions about the appropriateness of this treatment. Fever in infants can be a sign of an underlying infection, and while it is important to manage discomfort, the choice of medication is crucial. The standard recommendation for treating fever in infants is to use acetaminophen (Tylenol) rather than aspirin. Acetaminophen is considered safer and is effective in reducing fever and alleviating pain.

Regarding the frequency of aspirin use, administering it four times a day for an extended period, such as eight days, is not advisable for a newborn. If the infant is still feeling warm to the touch after this duration, it is essential to reassess the situation with a healthcare provider. Persistent fever may indicate an ongoing infection that requires further evaluation and possibly different treatment.

The presence of yellow, transparent mucus in the stool after starting aspirin could suggest gastrointestinal irritation, which is a known side effect of this medication. Aspirin can cause stomach upset, nausea, and even gastrointestinal bleeding in some cases, especially in sensitive populations like infants. If you notice any changes in your baby's stool or other concerning symptoms, it is crucial to consult a pediatrician immediately.

As for the definition of fever, it is important to note that normal body temperature can vary. Generally, a rectal temperature above 100.4°F (38°C) is considered a fever. However, axillary (armpit) temperatures are typically lower, and a reading of 98.6°F (37°C) in the armpit may not necessarily indicate fever. It is essential to use a reliable thermometer and follow the manufacturer's instructions for accurate readings.

In summary, aspirin is not a safe choice for treating fever in newborns. If your child is experiencing persistent fever or other symptoms, it is best to seek a second opinion from a pediatrician who can provide guidance on safe and effective treatment options. Acetaminophen is a more appropriate alternative for managing fever in infants, and any concerns about your child's health should be addressed promptly with a qualified healthcare professional. Always prioritize safety and consult with a doctor before administering any medication to your newborn.

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